Provider Demographics
NPI:1720373988
Name:SIMPSON, SHERYL ALICIA (NURSING)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:ALICIA
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:NURSING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:957 E 241ST ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-1050
Mailing Address - Country:US
Mailing Address - Phone:914-258-4466
Mailing Address - Fax:
Practice Address - Street 1:957 E 241ST ST APT 2R
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-1050
Practice Address - Country:US
Practice Address - Phone:914-258-4466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301319-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse